Fistula Clients in Mali, Attacked by Rebels, Recovered and are Receiving Care

By Carrie Ngongo, Project Manager, Fistula Care

On March 31, 2012, radical Islamists seized the city of Gao, in northern Mali. The rebel groups spared nothing, including Gao Regional Hospital. This Malian hospital is supported by EngenderHealth’s Fistula Care project, funded by the U.S. Agency for International Development (USAID), to offer repair surgery for women affected by obstetric fistula. The rebels forced fistula clients to flee into the streets, some still connected to their IVs. Fortunately, 12 of the 15 patients who had been hospitalized for fistula repair at the time of the attack have now been located.

Obstetric fistula is a debilitating condition that often results from obstructed delivery. Women living with fistula face chronic incontinence and are often neglected or abandoned by male partners and other family and community members. The Fistula Care project, managed by EngenderHealth and implemented by its partner IntraHealth International in Mali, has been working in northern Mali both to offer surgical care for fistula and to prevent the condition. For four years, we have supported hundreds of surgeries to repair obstetric fistula and have worked with public hospitals to improve the quality of maternal care. We partner with local organizations to let women with fistula know that they are not alone, that their problem can be treated.

These efforts, and the women receiving care at the time, were placed in jeopardy last March, when the attack occurred in Gao. As described in a blog post by IntraHealth, one fistula patient recounted her experience of the attack: “When the hospital was ransacked, we were all alone in the middle of the chaos… Even the bed I was sleeping on had been stolen. There were no longer any health workers to remove my catheter…”

Some of the women who escaped from the besieged hospital had not received care for nearly nine months. Fistula Care’s local partner, the Groupe de Recherche, d’Étude, de Formation Femme Action (GREFFA), successfully located these women and provided many of them with transportation to Mopti, southwest of Gao, where a surgical team could provide urgently needed treatment, care, and referrals.

A few of the women, though, declined to travel to Mopti for surgery, either because of the distance or for fear of being attacked by armed bandits on their way. This insecurity has also hindered efforts to locate the remaining fistula clients who fled the hospital in Gao.

EngenderHealth and the Fistula Care team, alongside the people of Mali, yearn for a peaceful future for the country. We hope that with improvements in security, all of the traumatized Gao fistula patients can receive services and the care that they need. Beyond these immediate efforts, there is also much work ahead to rebuild the Malian health system. With access to high-quality and timely childbirth care, women throughout Mali will be able to deliver their babies safely, without fear of obstetric fistula.